Ronald P D'Agostino DO PC
Organization Active NPI Family Medicine Physician · Lanse, MI
NPI 1548433360 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1548433360
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101008281 (MI)
- Legal business name
- RONALD P D'AGOSTINO DO PC
- Practice address
- 108 W Eastern Ave
Lanse, MI 49946-1214 - Phone
- (906) 524-6366
- Fax
- (906) 524-6014
- NPI assigned
- Apr 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Ronald P D'Agostino, DO
- Title
- President/Owner
- Phone
- (906) 524-7121
National Provider Directory
Locations
832 Sicotte St
Lanse, MI 49946
Phone (906) 225-5044
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 5101008281 | MI | Yes |
Addresses
Primary practice location
108 W Eastern Ave
Lanse, MI 49946-1214
Mailing address
108 W Eastern Ave
Lanse, MI 49946-1214
Phone (906) 524-7121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4137523 | Medicaid | MI | |
| 150700025 | Other | MI | BCBS RENDERING ID |
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All providers in Lanse, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.